Why you should care

In Africa, they create home brews so cheap that the illicit stuff far surpasses the demand for legal liquor. In Eastern Europe, they drink hand sanitizer and mouthwash just to get a buzz. And in parts of South and Central America, they pick up baggies full of pure ethanol from their pharmacists and mix it with Kool-Aid, coffee or Coca-Cola — bragging about their concoctions on social media while quietly hoping the creations are diluted enough to avoid causing catastrophic liver damage.

They are the desperate alcoholics of the world, ranging from impoverished Russians stomaching cologne to the underage punkeros of Colombia chugging the popular “chamberlain” booze made from antiseptics. And while rare, some nations particularly struggle with the abuse of alcohol products not meant for human consumption. For instance …

More than a third of the illicit alcohol consumption in El Salvador comes from surrogate alcohols — such as rubbing alcohol, vanilla extract and perfume.

Even in places with strict alcohol regulations, such as the United States, it’s not uncommon for underage kids to get drunk however they can, using dubious tactics like pounding the cold medicine NyQuil, which is about 10 percent alcohol.

What hasn’t been as easily available is a quantification of the myriad illegal ways people seek intoxication — until this year, when Euromonitor International analyzed recent research from 24 countries and found that roughly a quarter of all alcohol consumption is illegal, from watered-down rip-offs masquerading as quality name brands to regular products bootlegged to avoid taxation. That illegal black market is painful to the bottom line, to the tune of $3.6 billion in lost funds for local governments and businesses.

Even more agonizing, though, is the human cost, particularly when countries deal with surrogate alcohols, such as El Salvador and Russia, the study’s worst offenders in this niche, relatively rare type of illicit alcohol consumption. Drinking the isopropyl alcohol found in sanitizer can result in nervous system damage, blindness and organ failure. One 2011 survey of Russian working-age men who died from alcohol abuse found that some drank cologne, which can be between 60 and 90 percent alcoholic, in post-Soviet-era poverty — and that those men were nine times as likely to die from alcohol poisoning.

“When people get creative and start playing with ethanol, [that’s] when the accidents happen, and people die,” says Monica Ramirez, global director for regulatory and public policy at Anheuser-Busch InBev, the world’s largest brewer, which is one of several industry groups trying to work with local authorities and lawmakers to crack down on illicit alcohol consumption — partly out of concern for lost profits, but also out of concerns for public safety.

Meanwhile, Salvadorans often drink pure ethanol in plastic bags provided by their pharmacists and, as mentioned earlier, mixed with various drinks. “The reputation of alcoholic beverages isn’t very good in El Salvador among evangelicals. So it’s easy and cheap to go to a pharmacy and drink it” without attracting attention, Ramirez says. Higher-proof pure ethanol increases the risk of severe liver damage over time. And even when diluted, the clear liquid can easily contain other added toxins that are undetectable when just looking at it— at least 122 people in El Salvador died in 2000 after drinking low-quality liquor that had been mixed with methanol, in what officials suspected to be either a terrorist attack or an effort by anti-drinking groupsat social cleansing of alcoholics.

Shockingly, a social cleansing wouldn’t be all that unfathomable. In fact, that’s exactly what the United States government did to Americans in the 1920s, enlisting pharmacists to poison industrial alcohols in the hopes of scaring people out of illicit drinking. By the time Prohibition ended, at least 10,000 people had died as a result of what became known as the chemist’s war of Prohibition. A critic of the program, New York City chief medical examiner Charles Norris, reportedly called it “our national experiment in extermination,” but others defended it. “Must Uncle Sam guarantee safety first for souses?” the Omaha Bee in Nebraska opined, according to science journalist and novelist Deborah Blum, author of The Poisoner’s Handbook.

There are less brutal solutions today. In some countries, such as Panama and Mexico, industrial alcohols must be colored blue or purple using an aniline dye to broadcast toxicity. And nations that want to tackle their surrogate alcohol abuse problem can simply require that all alcoholic products not meant for human consumption be mixed with toxic chemicals that cause bad taste, nausea or vomiting — rather than death.